دورية أكاديمية
The changing shape of English general practice: a retrospective longitudinal study using national datasets describing trends in organisational structure, workforce and recorded appointments.
| العنوان: | The changing shape of English general practice: a retrospective longitudinal study using national datasets describing trends in organisational structure, workforce and recorded appointments. |
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| المؤلفون: | Pettigrew LM; Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK luisa.pettigrew@lshtm.ac.uk.; Research Department of Primary Care and Population Health, University College London, London, UK., Petersen I; Research Department of Primary Care and Population Health, University College London, London, UK.; Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark., Mays N; Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK., Cromwell D; Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK. |
| المصدر: | BMJ open [BMJ Open] 2024 Sep 03; Vol. 14 (8), pp. e081535. Date of Electronic Publication: 2024 Sep 03. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [London] : BMJ Publishing Group Ltd, 2011- |
| مواضيع طبية MeSH: | General Practice*/organization & administration , General Practice*/trends , State Medicine*/organization & administration , Appointments and Schedules*, Humans ; Retrospective Studies ; England ; Longitudinal Studies ; General Practitioners/trends ; Primary Health Care/organization & administration ; Primary Health Care/trends |
| مستخلص: | Objective: To describe trends in the organisational structure, workforce and recorded appointments by role in English general practice. Design: Retrospective longitudinal study. Setting: English general practice. Data Sources and Participants: NHS England, Office for Health Improvement and Disparities and Care Quality Commission national administrative datasets covering between 5 to 10 years from 2013 to 2023. Results: Between 2013 and 2023, the number of general practices fell by 20% from 8044 to 6419; the average practice list size increase by 40% from 6967 to 9724 patients. The total population covered by providers with over 100 000 registered patients reached 2.3 million in 2023 compared to 0.5 million in 2017. The proportion of practices under individual ownership decreased from 13% to 11% between 2018 and 2023; there was little change in the proportion owned by partnerships, incorporated companies or NHS bodies, which respectively averaged around 80.3%, 6.9% and 0.7%. Between 2015 and 2022, there was a 20% rise in the total full-time equivalent (FTE) general practice workforce, including Primary Care Network staff, from 1.97 to 2.37 per 1000 patients because of an increase in multidisciplinary other 'Direct Patient Care' (DPC) and administrative roles. The number of nurses remained stable, and the number of qualified general practitioners (GPs) decreased by 15%. In September 2022, there were 0.45 FTE qualified GPs per 1000 patients; GPs and other DPC roles, excluding nurses, each represented 19% of the FTE per 1000 patients workforce; administrative roles represented 51%. The general practice workforce is predominantly female. A quarter of GPs qualified overseas. Between 2018 and 2023, there was no clear upward or downward trend in total appointments per 1000 patients with, on average, half provided by GPs. Conclusions: Since 2013, there has been a shift in general practice towards larger practices with more multidisciplinary teams, alongside a reduction in the number of FTE qualified GPs per 1000 patients. We recommend that the impacts of these changes on access, quality and costs are closely monitored. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.) |
| فهرسة مساهمة: | Keywords: health policy; health services; health workforce; human resource management; primary health care |
| تواريخ الأحداث: | Date Created: 20240903 Date Completed: 20240903 Latest Revision: 20240903 |
| رمز التحديث: | 20240904 |
| DOI: | 10.1136/bmjopen-2023-081535 |
| PMID: | 39227175 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2044-6055 |
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| DOI: | 10.1136/bmjopen-2023-081535 |